Provider Demographics
NPI:1710505516
Name:CLAREMONT PHARMACY INC
Entity Type:Organization
Organization Name:CLAREMONT PHARMACY INC
Other - Org Name:CLAREMONT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MAYANK
Authorized Official - Middle Name:
Authorized Official - Last Name:BAROT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-662-0220
Mailing Address - Street 1:3181 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-3303
Mailing Address - Country:US
Mailing Address - Phone:212-662-0220
Mailing Address - Fax:
Practice Address - Street 1:3181 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-3303
Practice Address - Country:US
Practice Address - Phone:212-662-0220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-08
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY06323335Medicaid